Options dwindle for those in mental health crisis

The director of Island County’s Human Services department is warning of an impending “crisis in the crisis mental health system.”

Jackie Henderson discussed the situation with county commissioners last week and suggested a temporary fix locally, though finding the money may be difficult.

At the heart of the problem, Henderson said, is the scarcity of beds at in-patient mental health facilities in the state. In fact, she said Washington has the fewest number of such beds per capita in the nation.

And it’s getting worse. In-patient facilities continue to close because of the low reimbursement rate from the state. Even Western State Hospital is cutting the number of beds.

The problem begins when someone in the community has a mental health crisis and is not willing to go into treatment. On Whidbey Island, the person will likely end up at Whidbey General Hospital. The designated mental health professional decides if the person is a danger to him or herself or to others. If so, the patient needs to be involuntarily committed.

And then the waiting begins.

Henderson said officials will try to find a bed for the patient at in-patient mental health facility, but there’s no telling how long the wait may be. Or if an appropriate bed will ever open up. Between 10 and 15 people a month go through the involuntary commitment process in Island County.

In the meantime, the person in crisis just has to wait at the hospital. More than likely, a law enforcement officer must watch the volatile patient for a long period of time.

Henderson said deputies with the Coupeville Marshal’s Office used to take on the burden, but now the hospital hires reserve officers to guard the patients.

“It’s a burden on hospitals, it’s a burden on law enforcement and it’s not doing a person in a mental health crisis one bit of good to be sitting there next to a law enforcement officer,” she said.

It could be worse.

“If our law enforcement wasn’t so cooperative and compassionate, we could be tying people to gurneys,” she said. That’s what happens at Harborview Medical Center in Seattle, she said, where people tied to gurneys line the halls.

To make matters worse in Island County, Henderson said a detox center in Everett is closing. People in the county with chronic drug or alcohol problems are sometimes sent there to get help.

The wait for in-patient beds for chemical dependency treatment, she said, can be six months or more.

To ease the crisis, Henderson proposed the creation of a “triage center” in the county to deal with people suffering from acute mental health issues or drug or alcohol problems. The center would be a safe, temporary place for the patients staffed by medical professionals. It could be as simple as designating beds at Whidbey General Hospital for patients in mental health crises. The hospital doesn’t have the necessary “behavioral health staff,” Henderson said, but they could be hired. She plans to discuss the idea with the hospital board.

“We would need a couple of rooms in the hospital to hold people, keep them safe and get them the help they need until beds open up,” Henderson said.

Island County Commissioners John Dean and Helen Price Johnson were receptive to a proposal for a “safety net,” as Dean said, but they didn’t talk about funding proposals.

“As expensive as it is, we are already paying as a community,” Price Johnson said.

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